Chronic fatigue is a debilitating condition that has gained increasing attention in recent years, particularly in the context of long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These post-infectious syndromes have shed light on the complex nature of illnesses that can persist long after the initial infection has cleared.
Research conducted by Mass General Brigham investigator Anthony L Komaroff, MD, and Robert Dantzer, MD, of the MD Anderson Cancer Center, has identified common biological abnormalities underlying both long COVID and ME/CFS. These include neuroinflammation, mitochondrial dysfunction, immune dysregulation, endothelial dysfunction, gut dysbiosis, and oxidative stress. These abnormalities can directly cause symptoms and may persist due to the activation of specific brain circuits that evolved to respond to serious illness.
The COVID-19 pandemic has brought long COVID to the forefront, highlighting the similarities between post-acute infection syndromes like ME/CFS. The scale of long COVID’s impact has accelerated research and shifted public perception of these conditions. The biological parallels between ME/CFS and long COVID, such as brain abnormalities, autonomic nervous system dysfunction, immune dysregulation, impaired energy metabolism, and cardiovascular issues, suggest a shared pathophysiological foundation.
Currently, there are no FDA-approved treatments for ME/CFS or long COVID. However, targeting neuroinflammation, which drives symptoms by stimulating specific neural circuits, shows promise for future therapies. Experimental approaches to reduce neuroinflammation are currently being investigated.
Moving forward, research must address cross-condition biological parallels and therapeutic targeting of neuroinflammation to advance treatment and understanding of post-acute infection syndromes. Raising awareness of these conditions and promoting a framework for diagnosis and treatment will be crucial in improving outcomes for patients.
The study by Komaroff and Dantzer provides valuable insights into the underlying causes of chronic fatigue and post-acute infection syndromes, paving the way for more targeted and effective treatments in the future.
